Multiple and hereditary renal tumors: a review for radiologists.

80% of renal carcinomas (RC) are diagnosed incidentally by imaging. 2-4% of "sporadic" multifocality and 5-8% of hereditary syndromes are accepted, probably with underestimation. Multifocality, young age, familiar history, syndromic data, and certain histologies lead to suspicion of hereditary syndrome. Each tumor must be studied individually, with a multidisciplinary evaluation of the patient. Nephron-sparing therapeutic strategies and a radioprotective diagnostic approach are recommended. Relevant data for the radiologist in major RC hereditary syndromes are presented: von-Hippel-Lindau, Chromosome-3 translocation, BRCA-associated protein-1 mutation, RC associated with succinate dehydrogenase deficiency, PTEN, hereditary papillary RC, Papillary thyroid cancer- Papillary RC, Hereditary leiomyomatosis and RC, Birt-Hogg-Dubé, Tuberous sclerosis complex, Lynch, Xp11.2 translocation/TFE3 fusion, Sickle cell trait, DICER1 mutation, Hereditary hyperparathyroidism and jaw tumor, as well as the main syndromes of Wilms tumor predisposition. The concept of "non-hereditary" familial RC and other malignant and benign entities that can present as multiple renal lesions are discussed.

Adrenal pheochromocytoma: Keys to radiologic diagnosis.

Pheochromocytomas are adrenal paragangliomas. Potentially malignant, these tumors have a low incidence but clear importance. They can appear in various hereditary syndromes, especially in von Hippel-Lindau syndrome, multiple endocrine neoplasia-2 (MEN2), and familial paraganglioma syndromes. In sporadic cases, underlying genetic alterations are often found, and these findings are changing our understanding of the disease. Although these tumors can manifest with a characteristic clinical presentation, in 13.1%-57.6% of cases, it is the radiologist who first suggests the diagnosis, indicating analyses for catecholamines or nuclear medicine examinations. Radiologists should suspect a pheochromocytoma on detection of a well-delimited adrenal mass with rapid, intense enhancement that typically shows cystic and hemorrhagic phenomena, high T2 signal intensity, and the absence of macroscopic or microscopic lipids. The behavior in diffusion-weighted imaging usually does not provide very useful information. Approximately one-third of lesions show late washout similar to that seen with adenomas on CT. Percutaneous puncture should be avoided to avoid the risk of unleashing a severe hypertensive crisis.

Ultrasonography in infectious and neoplastic diseases of the bowel and peritoneum. / Ecografía de la patología infecciosa y tumoral del intestino y el peritoneo.

Ultrasonography is not the most cited imaging technique for the evaluation of infectious and neoplastic diseases of the gastrointestinal tract and the peritoneum, but it is often the initial technique used in the initial workup for nonspecific clinical syndromes. Despite its limitations, ultrasonography's strengths enable it to provide meaningful diagnostic information. To discuss the most important ultrasonographic, clinical, and epidemiological findings for infectious disease, we follow a topographical approach: stomach (Anisakis), proximal small bowel (Giardia lamblia, Strongyloides stercoralis, Mycobacterium avium-intracellulare complex, and Cryptosporidium), distal small bowel (Yersinia, Salmonella, and Campylobacter), terminal ileum and cecum (tuberculosis), right colon (Entamoeba histolytica), left colon (Shigella), sigmoid colon and rectum, pancolitis (Clostridium difficile, Cytomegalovirus, and Escherichia coli), and peritoneum. To discuss the ultrasonographic and clinical findings of the most common neoplastic diseases, we follow a nosological approach: polyploid lesions as precursors of tumors, carcinomas, neuroendocrine tumors, hematological tumors, mesenchymal tumors, and metastases. We briefly discuss tumors of the peritoneum and the use of ultrasonography to guide percutaneous biopsy procedures.

SARS-CoV-2: what it is, how it acts, and how it manifests in imaging studies. / SARS-CoV-2: cómo es, cómo actúa y cómo se expresa en la imagen.

COVID-19 is a disease with many clinical, biochemical, and radiological signs that has a predilection for the lungs, probably because of the high number of ACE-2 receptors in this organ. The infection of cells activates proinflammatory substances, causing diffuse alveolar damage, which is the histopathological basis of ARDS. The exudative phase would manifest as ground-glass opacities and consolidation, and the proliferative phase would manifest as a tendency toward a more linear morphology. Both CT and PET/CT findings support the inflammatory character of the lung lesions in the initial phase of the disease and in patients with mild-moderate disease. Severe cases have pulmonary hypoperfusion that is likely due to abnormal alveolar ventilation and perfusion. On the other hand, a prothrombotic state increases the risk of thromboembolic disease through the activation of coagulation and platelet pathways with the production of fibrin degradation products (D-dimer) and consumption of platelets.

SARS-CoV-2: cómo es, cómo actúa y cómo se expresa en la imagen / SARS-CoV-2: what it is, how it acts, and how it manifests in imaging studies

La COVID-19 es una enfermedad con una gran semiología clínica, bioquímica y radiológica, que tiene una afectación preferente por el pulmón, probablemente debido a un mayor número de receptores ECA-2. La infección celular activa sustancias proinflamatorias y provoca un daño alveolar difuso, que es la base histopatológica del distrés respiratorio del adulto. La fase exudativa explicaría las imágenes "en vidrio deslustrado" y consolidación, mientras que la tendencia hacia una morfología más lineal representa la fase proliferativa. Tanto la tomografía computarizada (TC) como la tomografía por emisión de positrones/ tomografía computarizada (PET/TC) apoyan el carácter inflamatorio de las lesiones pulmonares cuando la enfermedad está en fase inicial o es leve-moderada. Los casos graves muestran una hipoperfusión pulmonar que se explicaría por una alteración de la ventilación-perfusión alveolar (V/Q). Por otro lado, un estado protrombótico conlleva mayor probabilidad de enfermedad tromboembólica por la activación de la vía de la coagulación y plaquetaria, con la producción de sustancia de degradación de la fibrina (dímero D) así como el consumo de plaquetas

COVID-19 is a disease with many clinical, biochemical, and radiological signs that has a predilection for the lungs, probably because of the high number of ACE-2 receptors in this organ. The infection of cells activates proinflammatory substances, causing diffuse alveolar damage, which is the histopathological basis of ARDS. The exudative phase would manifest as ground-glass opacities and consolidation, and the proliferative phase would manifest as a tendency toward a more linear morphology. Both CT and PET/CT findings support the inflammatory character of the lung lesions in the initial phase of the disease and in patients with mild-moderate disease. Severe cases have pulmonary hypoperfusion that is likely due to abnormal alveolar ventilation and perfusion. On the other hand, a prothrombotic state increases the risk of thromboembolic disease through the activation of coagulation and platelet pathways with the production of fibrin degradation products (D-dimer) and consumption of platelets

The radiologist's role in the management of papillary renal cell carcinoma. / Carcinoma papilar de células renales: el papel del radiólogo en su manejo.

Papillary carcinoma is the second most common renal cell carcinoma. It has a better prognosis than the more frequent clear cell carcinoma, although this does not hold true for advanced cases, because no specific treatment exists. It presents as a circumscribed peripheral tumor (small and homogeneously solid or larger and cystic/hemorrhagic) or as an infiltrating lesion that invades the veins, which has a worse prognosis. Due to their low vascular density, papillary renal cell carcinomas enhance less than other renal tumors, and this facilitates their characterization. On computed tomography, they might not enhance conclusively, and in these cases they are impossible to distinguish from hyperattenuating cysts. Contrast-enhanced ultrasonography and magnetic resonance imaging are more sensitive for detecting vascularization. Other characteristics include a specific vascular pattern, hypointensity on T2-weighted images, restricted water diffusion, and increased signal intensity in opposed phase images. We discuss the genetic, histologic, clinical, and radiological aspects of these tumors in which radiologists play a fundamental role in management.

Esophageal cancer: anatomic particularities, staging, and imaging techniques. / Cáncer de esófago: particularidades anatómicas, estadificación y técnicas de imagen.

Cancer of the esophagus is a tumor with aggressive behavior that is usually diagnosed in advanced stages. The absence of serosa allows it to spread quickly to neighboring mediastinal structures, and an extensive lymphatic drainage network facilitates tumor spread even in early stages. The current TNM classification, harmonized with the classification for gastric cancer, provides new definitions for the anatomic classification, adds non-anatomic characteristics of the tumor, and includes tumors of the gastroesophageal junction. Combining endoscopic ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging provides greater accuracy in determining the initial clinical stage, and these imaging techniques play an essential role in the selection, planning, and evaluation of treatment. In this article, we review some particularities that explain the behavior of this tumor and we describe the current TNM staging system; furthermore, we discuss the different imaging tests available for its evaluation and include a diagnostic algorithm.

Función sistólica del ventrículo izquierdo: cómo comprenderla y analizarla / Left ventricular systolic function: How to understand it and analyze it

En los estudios de resonancia magnética cardíaca, la función sistólica del ventrículo izquierdo suele calcularse automáticamente. Entender cómo se obtiene cada parámetro de la función y el por qué de las diferencias que pueden existir entre los valores obtenidos con dos técnicas, por ejemplo ecografía y resonancia magnética, es fundamental para comprenderlas e interpretarlas adecuadamente. En este artículo se detalla el análisis habitual de la función sistólica desde un punto de vista cuantitativo y cualitativo, y se explican otros métodos que no requieren un software específico. Hemos diseñado (y lo aportamos para que pueda usarse libremente) un fichero que, empleando el programa Microsoft Excel®, permite analizar la función sistólica sencilla e intuitivamente (AU)

In cardiac magnetic resonance imaging studies, left ventricular systolic function is usually calculated automatically. To understand and interpret parameters of left ventricular systolic function correctly, it is fundamental to understand how each parameter is obtained and why values obtained with different techniques, for example, ultrasonography and magnetic resonance imaging, can differ. This article provides details about the usual analysis of systolic function from the quantitative and qualitative points of view; it also explains other methods that do not require specific software. Moreover, we provide a file that we designed for use with Microsoft Excel® to enable simple, intuitive analysis of systolic function. Readers can use this file freely (AU)

[Left ventricular systolic function: how to understand it and analyze it]. / Función sistólica del ventrículo izquierdo: cómo comprenderla y analizarla.

In cardiac magnetic resonance imaging studies, left ventricular systolic function is usually calculated automatically. To understand and interpret parameters of left ventricular systolic function correctly, it is fundamental to understand how each parameter is obtained and why values obtained with different techniques, for example, ultrasonography and magnetic resonance imaging, can differ. This article provides details about the usual analysis of systolic function from the quantitative and qualitative points of view; it also explains other methods that do not require specific software. Moreover, we provide a file that we designed for use with Microsoft Excel(®) to enable simple, intuitive analysis of systolic function. Readers can use this file freely.

Cómo escribir un artículo. Cuestiones formales / How to write an article: formal aspects

La investigación científica y la publicación de sus resultados van de la mano. Una metodología investigadora exquisita solo puede ser reflejada adecuadamente por una publicación formal y estructuralmente óptima. Para el éxito de este proceso deben seguirse unos pasos ordenados, que incluyen la selección de la revista en que publicar y la adhesión estricta a sus normas y a las guías metodológicas y formales que ofrecen diversas sociedades de editores y otras instituciones. Además, se requiere una escritura con contenidos estructurados, lógicos y atractivos y un estilo basado en las premisas de la precisión, la claridad y la concisión. La tarea de redacción científica es colectiva, aunque no todos los autores la protagonicen directamente, y no termina hasta que el artículo está publicado. En estas páginas encontrará consejos prácticos sobre pormenores formales, y no tan formales de la escritura científica, y referencias donde ampliarlos y detallarlos (AU)

Scientific research and the publication of the results of the studies go hand in hand. Exquisite research methods can only be adequately reflected in formal publication with the optimum structure. To ensure the success of this process, it is necessary to follow orderly steps, including selecting the journal in which to publish and following the instructions to authors strictly as well as the guidelines elaborated by diverse societies of editors and other institutions. It is also necessary to structure the contents of the article in a logical and attractive way and to use an accurate, clear, and concise style of language. Although not all the authors are directly involved in the actual writing, elaborating a scientific article is a collective undertaking that does not finish until the article is published. This article provides practical advice about formal and not-so-formal details to take into account when writing a scientific article as well as references that will help readers find more information in greater detail (AU)

[How to write an article: formal aspects]. / Cómo escribir un artículo. Cuestiones formales.

Scientific research and the publication of the results of the studies go hand in hand. Exquisite research methods can only be adequately reflected in formal publication with the optimum structure. To ensure the success of this process, it is necessary to follow orderly steps, including selecting the journal in which to publish and following the instructions to authors strictly as well as the guidelines elaborated by diverse societies of editors and other institutions. It is also necessary to structure the contents of the article in a logical and attractive way and to use an accurate, clear, and concise style of language. Although not all the authors are directly involved in the actual writing, elaborating a scientific article is a collective undertaking that does not finish until the article is published. This article provides practical advice about formal and not-so-formal details to take into account when writing a scientific article as well as references that will help readers find more information in greater detail.

Análisis de la función diastólica del ventrículo izquierdo mediante resonancia magnética / Analysis of left ventricular diastolic function using magnetic resonance imaging

La insuficiencia cardíaca no siempre es debida a una alteración sistólica, y una disfunción diastólica puede explicar muchos casos de insuficiencia cardíaca con función sistólica normal. La función diastólica depende de la capacidad de llenado del ventrículo izquierdo para garantizar un volumen latido normal. Se mide rutinariamente con la ecocardiografía transtorácica, ya que se trata de una prueba no invasiva y de gran accesibilidad. La resonancia magnética (RM), utilizando secuencias de flujo, muestra una buena concordancia con la ecocardiografía, analizando la función diastólica de forma práctica, a través del flujo en la válvula mitral y las venas pulmonares. En este sentido, el análisis de la función diastólica debería añadirse como parte de un examen rutinario de RM cardíaca (AU)

Heart failure is not always due to an alteration in systolic function, and a diastolic dysfunction could explain many cases of heart failure with a normal systolic function. Diastolic function depends on the left ventricular filling capacity to ensure a normal stroke volume. It is routinely measured with transthoracic echocardiography, as it is an easily accessible non-invasive test. The MRI, using flow sequences, shows good agreement with the echocardiography, analysing the diastolic function in a practical way, by the flow into the mitral valve and pulmonary veins. In this sense, the analysis of diastolic function should be added as part of a routine cardiac MR examination (AU)

[Analysis of left ventricular diastolic function using magnetic resonance imaging]. / Análisis de la función diastólica del ventrículo izquierdo mediante resonancia magnética.

Heart failure is not always due to an alteration in systolic function, and a diastolic dysfunction could explain many cases of heart failure with a normal systolic function. Diastolic function depends on the left ventricular filling capacity to ensure a normal stroke volume. It is routinely measured with transthoracic echocardiography, as it is an easily accessible non-invasive test. The MRI, using flow sequences, shows good agreement with the echocardiography, analysing the diastolic function in a practical way, by the flow into the mitral valve and pulmonary veins. In this sense, the analysis of diastolic function should be added as part of a routine cardiac MR examination.

El proceso editorial en Radiología / The editorial process for Radiología

Radiología es la revista oficial de la Sociedad Española de Radiología Médica. Su objetivo es contribuir a la formación de los radiólogos de habla hispana y divulgar el conocimiento y la investigación radiológicos en esta lengua. Tiene un Comité Editorial estructurado en áreas o secciones y basa la selección y mejora de sus contenidos en un sistema de revisión por iguales (peer review). En este artículo se discuten el modelo de revista científica que pretende ser Radiología, las características de su Comité Editorial en comparación con los de otras revistas radiológicas generales representantes oficiales de sociedades científicas y los pormenores del proceso editorial en la revista, abarcando el tránsito de un manuscrito por su circuito editorial, la labor de los revisores, el proceso de edición técnica final y datos cualitativos y cuantitativos del material que Radiología recibe y publica (AU)

Radiología is the official journal of the Spanish Society of Diagnostic Imaging. It aims to contribute to the education of Spanish-speaking radiologists and to disseminate radiological research and knowledge in Spanish. The journal has an Editorial Board organized into areas or sections, and material published in the journal is chosen and improved through peer review. This article discusses the model of the scientific journal Radiología and the characteristics of its Editorial Board, comparing Radiología with official general radiology journals of other scientific societies. Moreover, the details of the journal's editorial process are revealed, including the editorial circuit, the reviewers’ work, and the technical aspects of the final edition process. Finally, the article lists qualitative and quantitative data about the material that Radiología receives and publishes (AU)

[The editorial process for Radiología]. / El proceso editorial en Radiología.

Radiología is the official journal of the Spanish Society of Diagnostic Imaging. It aims to contribute to the education of Spanish-speaking radiologists and to disseminate radiological research and knowledge in Spanish. The journal has an Editorial Board organized into areas or sections, and material published in the journal is chosen and improved through peer review. This article discusses the model of the scientific journal Radiología and the characteristics of its Editorial Board, comparing Radiología with official general radiology journals of other scientific societies. Moreover, the details of the journal's editorial process are revealed, including the editorial circuit, the reviewers' work, and the technical aspects of the final edition process. Finally, the article lists qualitative and quantitative data about the material that Radiología receives and publishes.

[Spontaneous cutaneous umbilical endometriosis]. / Endometriosis cutánea umbilical espontánea.

Endometriosis consists of extrauterine endometrial growths. Although it is usually located in the pelvis it can also be found in other sites. Endometriosis of the skin is rare and the most frequent form develops over gynecologic or obstetric scars, although it may also appear spontaneously in the umbilical area. We present a 39-years-old woman with an umbilical nodule as a clinically characteristic form of spontaneous cutaneous endometriosis. The histopathological examination confirmed the clinical diagnosis.